CSA Form 106

Report of Theft or Loss of Controlled Substances
Under Controlled Substances Act of 1970

INSTRUCTIONS for Form DEA-106, Report of Theft or Loss of Controlled Substances - Approved OMB Form No. 1117-0001 Expires: 08/31/2014

General Instructions

WHAT'S NEW

Changes to the Controlled Substances Section. The DEA is now requiring registrants to enter the National Drug Code (NDC) of the controlled substances lost or stolen.

Discontinued Fields. With the implementation of the NDC number, DEA will no longer require registrants to enter specific information pertaining to product lost or stolen. Inputting the NDC number will auto-populate all required information needed for data collection and report generation.

Purpose of Form

The DEA-106 is for reporting any theft or loss of controlled substances.
Do not use this form if:
1.  You have not previously registered with the DEA,
2.  The theft or loss you are reporting is not of a controlled substance, or
3.  You want to correct minor inventory shortages.

Additional Information

The online version of Form DEA 106 has 8 sections. What follows is a description of each section and the information you will need to successfully fill out this online form. Please note that for all pages where you are required to supply information, there is a section labeled "Help." For any field on the page for which you require clarification, place the cursor in the field and click. Help text will appear in the Help section.

SPECIFIC INSTRUCTIONS

Section 1. Authentication and Report Selection
You will be asked to enter your DEA Number and your last name or the business name you used to register with the DEA. The name you supply must match exactly the name on your registration. You will be able to choose whether to file a new report or amend a report previously entered.
Section 2. Theft/Loss Details
You will be asked to provide background information relating to this loss or theft incident, such as the date and place, the type (night break-in, armed robbery, etc.), and the estimated value of the controlled substances, etc. Responses may require additional information; for example, indicating that a police report has been filed will open new fields requesting the police department's name and telephone number.
Section 3. Controlled Substances
You will be asked to provide the National Drug Code (NDC) and quantity of the controlled substance being reported as a theft or loss. If the substance is liquid or powder, you will need to enter the total milliliters/milligrams; if tablet, enter the total count of tablets.
Section 4. Signature
You will be asked to supply the name and title of the person filing this report.
Section 5. Theft/Loss Summary
Information regarding the details of the theft or loss will be presented to you for confirmation; changes to the information may be made. You may also change information in the Signature section.
Section 6. Controlled Substances Summary and Certification
Information on the substances will be displayed, and may be changed. Additionally, you will be required to enter the name of the certifying official who attests to the validity of the information included in the report.
Section 7. Submit Report
Submitting the report will generate an amendment key. Please save the amendment key in order to be able to modify information using the online DEA-106 report in the future.
Section 8. Print
You may send a copy of the DEA-106 report to your local printer. DEA regulations specify that you keep a copy of this report for two years.

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